Unusual presentations of Abdominal Tuberculosis: a case series of clinical mysteries

ObjectiveTo provide an insight into the presentation, diagnosis and management of paediatric abdominal tuberculosis (TB) in developed countries.MethodsThe records of all children at the Montreal Children's Hospital (MCH) admitted with abdominal TB between 1990 and 2014 were reviewed. An automated and manual literature search from 1946 to 2014 was performed.Results(1) Case series: six cases were identified at the MCH. All were male between 5 and 17 years of age. All were from populations known to have high rates of TB (aboriginal, immigrant). Three underwent major surgical interventions and three underwent ultrasound (US) or CT aspiration or biopsy for diagnosis. (2) Literature review: 29 male (64%) and 16 female subjects (36%) aged between 14 months and 18 years were identified, including the MCH patients. All patients except one were from populations with a high incidence of TB. Most presented with a positive tuberculin skin test (90%), abdominal pain (76%), fever (71%) and weight loss (68%). On imaging, 22 (49%) were classified with gastrointestinal TB with colonic wall irregularity (41%) and 19 (42%) with peritoneal TB with ascites (68%). A positive culture was obtained in 33 (73%) patients. Three cases used CT- or US-guided aspiration or biopsy to obtain tissue samples. A surgical intervention was performed in 34 (76%) children; 13 (38%) of these were for diagnosis.ConclusionsDiagnosis based on clinical features (abdominal pain, fever and weight loss) and CT- or US-guided aspiration or biopsy may encourage physicians to adopt a more conservative approach to abdominal TB.

Download Full-text

The diagnostic challenge of abdominal tuberculosis in nonendemic countries: A case series from a tertiary hospital in Germany

Clinical Case Reports ◽

10.1002/ccr3.4524 ◽

2021 ◽

Vol 9 (7) ◽

Author(s):

Maya Bertlich ◽

Maria Paparoupa ◽

Helgard Weckauf ◽

Andreas Wittig ◽

Stephan Linnemüller ◽

...

Keyword(s):

Case Series ◽

Abdominal Tuberculosis ◽

Tertiary Hospital ◽

Diagnostic Challenge

Download Full-text

Abdominal Tuberculosis – A Clinical Perplexity In Diagnosing Acute Abdomen: Case series

IOSR Journal of Dental and Medical Sciences ◽

10.9790/0853-1603065561 ◽

2017 ◽

Vol 16 (03) ◽

pp. 55-61

Author(s):

Dr. Harika Kapu ◽

Dr. R.K. Shastri ◽

Dr. Kagitha Usha Rani

Keyword(s):

Acute Abdomen ◽

Case Series ◽

Abdominal Tuberculosis

Download Full-text

ABDOMINAL TUBERCULOSIS

The Professional Medical Journal ◽

10.29309/tpmj/2008.15.03.2829 ◽

2008 ◽

Vol 15 (03) ◽

pp. 354-360

Author(s):

SHEIKH ATIQ-UR- REHMAN ◽

GULZAR AHMED ◽

AHMED YAR

Keyword(s):

Iliac Fossa ◽

Case Series ◽

Abdominal Tuberculosis ◽

Surgical Units ◽

Clinical Presentations ◽

Case Series Study ◽

Biopsy Report ◽

History Of ◽

Series Study

Objectives: To study the different clinical presentations, operative and postoperative course ofabdominal tuberculosis. Design: Case series study. Setting: Surgical units, Bahawal Vicotria Hospital, Bahawalpur .Period: May 01, 2005 to April 30, 2007. Patients & Method: This was a prospective type of case series study. Aselection criterion of patients was that all patients of either sex & age being diagnosed as case of abdominaltuberculosis. The clinical record of the patient’s data, symptoms & signs, biopsy report, biochemical & radiologicalreport, treatment (surgery & chemotherapy) given and a follow-up. Results: Total 96 patients presented with abdominaltuberculosis, 60(62.5%) were male & 36(37.5%) were female. Peritonitis was present in 48(50%) patients, intestinalobstruction(acute & sub-acute) was present in 32(33.33%) patients, mass right iliac fossa was present in 14(14.58%)patients and 2(2.08%) patient presented with mass in the epigastrium. 28(29.16%) patients has concurrent pulmonarytuberculosis. Two patients expired so mortality rate was 2.08%. Conclusion: The control of TB has been a challengingproblem because the natural history of the disease and its varying pattern in which it manifests is in different groups.

Download Full-text

PRIMARY ABDOMINAL TUBERCULOSIS, 2 CASE SERIES REPORT AND LITERATURE REVIEW

10.36106/ijar/7414718 ◽

2021 ◽

pp. 20-24

Author(s):

Júlia Guimarães Pereira ◽

Renata de Oliveira Belo Custódio dos Santos ◽

Stephannie Glozan Virgulino ◽

Giovanna Paliares Monteiro ◽

Mariana Mussalem Santos ◽

...

Keyword(s):

Clinical Symptoms ◽

Case Series ◽

Abdominal Tuberculosis ◽

The Body ◽

Human Beings ◽

Main Site ◽

High Clinical Suspicion ◽

Case Series Report ◽

Global Health Problem ◽

Series Report

Tuberculosis (TB), an infectious disease caused by Mycobacterium tuberculosis, is a disease that has affected human beings since antiquity and is still a global health problem. The main site of TB is usually in the lung, from where it can spread to other parts of the body. However, it can also present in extrapulmonary forms, the most common being the abdominal. Abdominal tuberculosis is dened as an infection of the gastrointestinal tract, peritoneum, abdominal solid organs, and/or abdominal lymphatics. Because its clinical symptoms are nonspecic, the diagnosis of abdominal tuberculosis requires a high clinical suspicion, especially in the predisposed population

Download Full-text

A diagnostic approach for differentiating abdominal tuberculosis from ovarian malignancy: a case series and literature review

BMC Proceedings ◽

10.1186/s12919-019-0180-y ◽

2019 ◽

Vol 13 (S11) ◽

Cited By ~ 1

Author(s):

Moh Nailul Fahmi ◽

Annisaa Pelita Harti

Keyword(s):

Ovarian Cancer ◽

Extrapulmonary Tuberculosis ◽

Clinical Manifestations ◽

Case Series ◽

Abdominal Tuberculosis ◽

Diagnostic Approach ◽

Ca 125 ◽

Imaging Features ◽

Ovarian Malignancy ◽

Cancer Antigen 125

Abstract Background Abdominal tuberculosis is an uncommon variant of extrapulmonary tuberculosis. It accounts for 3.5% of extrapulmonary tuberculosis. Diagnosis of abdominal tuberculosis is still a challenge due to its non-specific symptoms. Abdominal tuberculosis and ovarian cancer may show similar symptoms, laboratory and imaging features. The goal of our report is to emphasize for the need of a diagnostic approach based on clinical manifestations, laboratory, imaging findings, and additional tests for considering a diagnosis of abdominal tuberculosis rather than ovarian cancer. Case presentation We report 3 cases of abdominal tuberculosis in our Onco-gynaecology Division, Department of Obstetrics and Gynaecology, Sardjito Hospital, Yogyakarta, Indonesia in 2018 which were previously diagnosed as ovarian malignancy and managed surgically. All of our patients experienced abdominal pain and enlargement but only two of them had significant weight loss. The general symptoms were typically found in onco-gynaecology patients, especially in those with ovarian malignancy. Ultrasound examination showed multilocular masses, 2 of them with solid parts and ascites. Cancer antigen 125 (CA-125) levels were found increasing in those three patients. All of them were treated surgically and diagnosis of abdominal tuberculosis was established through the histopathological result of tissue biopsy. Based on our cases and literature, we consider the need of a diagnostic approach to differentiate abdominal tuberculosis from ovarian malignancy, an attempt to avoid unnecessary invasive procedures that put burden risk for the patients. Conclusion Minimally invasive tests to establish the diagnosis of abdominal tuberculosis should be optimized to reduce the burden risk of laparotomy. Careful diagnostic steps should be followed to avoid wrong diagnosis.

Download Full-text

STUDY OF CURRENT PATTERN OF MECHANICAL INTESTINAL OBSTRUCTION IN ADULTS AT DMCH, LAHERIASARAI, BIHAR

10.36106/ijsr/2027427 ◽

2020 ◽

pp. 46-47

Author(s):

Ravindra Kumar Ravi ◽

Vijay Shankar Prasad ◽

Debarshi Jana

Keyword(s):

Mortality Rate ◽

Intestinal Obstruction ◽

Bowel Obstruction ◽

Case Series ◽

Abdominal Tuberculosis ◽

Clinical Findings ◽

Current Pattern ◽

Female Ratio ◽

Mechanical Intestinal Obstruction ◽

Mechanical Bowel Obstruction

Objective : To evaluate the current pattern of mechanical bowel obstruction in adults. Study design : Descriptive case series. Place & Duration of study : Upgraded Department of Surgery, DMCH, Laheriasarai, Bihar, from March 2019 to February 2020. Methodology : The criteria for diagnosis were on the basis of history, clinical findings, radiological examination, exploration of abdomen and histopathological confirmation in selected cases. Results : A total of 252 surgically treated cases of mechanical bowel obstruction were included. Out of the total, 187 (74.2%) presented with acute and 65 (25.8%) with sub-acute intestinal obstruction. The mean age was 37.4 years with male to female ratio of 2:1. Abdominal tuberculosis was found in 77 (30.6%) patients. Among the other causes bands/adhesions were found in 57 patients (22.6%) and obstructed hernias in 44 patients (17.5%). In 161 patients (64%) the intestinal obstruction was without gut compromise, while in 91 patients (36%) strangulated bowel obstruction was present. Forty patients (15.9%) developed postoperative complications mainly wound sepsis and chest problems in the form of atelectasis and pneumonia. The mortality rate was 2.4% (n 6). Conclusions : Tuberculosis is still the common cause of intestinal obstruction, with overall mortality rate of 2.4% which needs attention.

Download Full-text